The Government has announced it will abolish NHS England in a bid to ‘strip out duplication’ with the Department of Health and Social Care (DHSC).
The move is to set to reduce bureaucracy, make savings and empower NHS staff to deliver better care for patients, according to the DHSC.
According to the announcement, NHS England ‘will be brought back into the DHSC entirely’ to ‘put an end to the duplication resulting from ‘two organisations doing the same job’ and ‘more resources will be put back into the frontline rather than being spent on unnecessary admin’.
The Government said the move would ‘reduce complex bureaucracy’ and ‘undo the damage caused by 2012 reorganisation’, led by then-health secretary Andrew Lansley and which saw the formation of NHS England as an arms-length body in 2013.
‘The reforms will reverse the 2012 top-down reorganisation of the NHS which created burdensome layers of bureaucracy without any clear lines of accountability. As Lord Darzi’s independent investigation into the state of the NHS found, the effects of this are still felt today and have left patients worse off under a convoluted and broken system,’ the announcement said.
The Government said that in practice this will mean:
- Work will begin immediately to return many of NHS England’s current functions to the Department
- A longer-term programme of work will deliver the changes to bring NHS England back into the Department.
The plans will also see ‘more power and autonomy to local leaders and systems’, the Government added.
‘Devolving resources and responsibilities to the NHS frontline’
In a statement to Parliament, health secretary Wes Streeting said: ‘This is the final nail in the coffin of the disastrous 2012 reorganisation, which led to the longest waiting times, lowest patient satisfaction, and most expensive NHS in history.
‘When money is so tight, we can’t justify such a complex bureaucracy with two organisations doing the same jobs. We need more doers, and fewer checkers, which is why I’m devolving resources and responsibilities to the NHS frontline.
‘NHS staff are working flat out but the current system sets them up to fail. These changes will support the huge number of capable, innovative and committed people across the NHS to deliver for patients and taxpayers.
‘Just because reform is difficult doesn’t mean it shouldn’t be done. This Government will never duck the hard work of reform. We will take on vested interests and change the status quo, so the NHS can once again be there for you when you need it.’
‘Build an NHS fit for the future’
Sir James Mackey, who has been named transition CEO of NHS England, said: ‘We know that while unsettling for our staff, today’s announcement will bring welcome clarity as we focus on tackling the significant challenges ahead and delivering on the Government’s priorities for patients.
‘From managing the Covid pandemic, the biggest and most successful vaccine campaign which got the country back on its feet, to introducing the latest most innovative new treatments for patients, NHS England has played a vital role in improving the nation’s health. I have always been exceptionally proud to work for the NHS – and our staff in NHS England have much to be proud of.
‘But we now need to bring NHS England and DHSC together so we can deliver the biggest bang for our buck for patients, as we look to implement the three big shifts – analogue to digital, sickness to prevention, and hospital to community – and build an NHS fit for the future.”
Incoming NHS England chair Dr Penny Dash said: ‘I am committed to working with Jim, the board and wider colleagues at NHS England to ensure we start 25/26 in the strongest possible position to support the wider NHS to deliver consistently high-quality care for patients and value for money for taxpayers.
‘I will also be working closely with Alan Milburn to lead the work to bring together NHSE and DHSC to reduce duplication and streamline functions.’
‘End of an era for the NHS‘
In a joint statement in response to the news, Matthew Taylor, chief executive of the NHS Confederation, and Daniel Elkeles, incoming chief executive of NHS Providers, said: ‘This is the end of an era for the NHS and marks the biggest reshaping of its national architecture in a decade.
‘Our members will understand the dynamics at play here, but it comes at an extremely challenging time, with rising demand for care, constrained funding and the need to transform services. History tells us this will cause disruption while the transition is taking place. Much of Trust and [integrated care system] ICS leaders’ focus will need to go on stabilising the NHS in the short term as they prioritise patient care but we also need to ensure we get the right balance between recovery and reform given the opportunity provided by the upcoming 10-year plan.
‘Our members will want to see strong voices maintained for the health service in future policy making and the major decisions that affect leaders and their staff. NHS England was set up to provide arms-length operational independence for the NHS from Government and it will be important that the service maintains its ability to inform policy-making and all decisions that affect operational delivery.
‘The NHS Confederation and NHS Providers and our diverse memberships will work with the Government to help this transition go smoothly and to ensure the 10-year plan helps the Government to meet its ambitions. Local NHS organisations and other bodies will need to be involved in this transformation as the immediate next steps become clearer, so that an optimum operating model can be created.‘
A version of this article was originally published by our sister publication Pulse.
